Provider Demographics
NPI:1114450715
Name:RICE, JAY STONE (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:STONE
Last Name:RICE
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 FRANCISCO BLVD E STE J
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5523
Mailing Address - Country:US
Mailing Address - Phone:415-485-1388
Mailing Address - Fax:
Practice Address - Street 1:2173 FRANCISCO BLVD E STE J
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5523
Practice Address - Country:US
Practice Address - Phone:415-485-1388
Practice Address - Fax:415-897-7227
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT19107106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist